State REC Ready to Assist Providers as Decision Time Nears

Hurry up and wait ... providers have been sitting on 'go' for more than a year now as federal agencies debate the final definition of 'meaningful use,' prepare to appoint certifying bodies and anoint certified vendors. Now, it appears pieces are almost in place, and the rush will be on to install systems that satisfy the criteria for HITECH incentives.

Standing at the ready to meet the onslaught of questions is Tennessee's Regional Extension Center (REC), which is manned by QSource, the state's quality improvement organization. In February of this year, the Office of the National Coordinator for Health Information Technology (ONC) named 60 RECs in the United States. Tennessee is one of the lucky states with assistance available to every county. In California, however, there are three RECs, but none of them cover the huge population of Orange County. "You have pockets that actually don't have any assistance available, but ONC is trying to remedy that," noted Jennifer McAnally, tnREC director.

Tennessee also has a cohesive team working together to support providers as they move to electronic health records (EHRs). In addition to tnREC, the Office of eHealth, HIT-TN and TennCare all meet regularly to coordinate efforts. "It's really well organized and orchestrated," said McAnally. "You don't see that in other states. We hear from other states how they are envious about how Tennessee put this together." She added the credit goes to the state's leadership for making eHealth a priority.

For hospitals, clinics and practices making the move to EHRs and striving to hit the mandatory meaningful use benchmarks, tnREC is there to assist. "Let us help put you on a path so that you can meet all these milestones to achieve your additional reimbursements," she said. "That's what we're here to do is help you become a meaningful user of your electronic health record."

McAnally said that while tnREC doesn't actually install the system, they can assist with just about every other aspect of getting an EHR up and running including helping providers avoid common pitfalls of choosing and installing a system. Although tnREC is vendor neutral, the organization will help a practice create a short list of vendors and even do an assessment to see which vendor is the best fit to meet the health entity's criteria. "But the ultimate decision is up to the practice," McAnally stressed.

She noted tnREC representatives are also there to help providers and administrators better understand what the final meaningful use requirements mean to those in the trenches. "Health and Human Services actually backed off on how strenuous they were. They made all the criteria more attainable. That's good news," she said.

"They also reduced the number of measures practices have to report on," McAnally continued. She said originally there were 25 reporting criteria and all were mandatory. Now there are a total of 20 measures ... a core set of 15 criteria for everyone plus a menu set from which providers must pick an additional five that best fit the parameters of their specific practice. McAnally did add that states could require additional criteria after receiving approval from ONC. However, Tennessee had not added any additional standards as of press time.

Hitting the benchmarks was also made easier with the final rule. The initial requirements had very high adoption rates to be considered meaningful use. "The percentages have been greatly reduced. They've come off those really high numbers," said McAnally. The initial target for CPOE was in the 70-75 percent range and has now been dropped to 30 percent. Similarly, the original mandate was for 75 percent of prescriptions to be e-prescribed to hit the threshold of being a meaningful user. Now, it has been dropped to 40 percent. McAnally said this target should also be much easier to achieve since the Drug Enforcement Agency began allowing the e-prescription of controlled substances back in June.

Once healthcare facilities begin to adopt CPOE and e-prescribing, McAnally predicted utilization numbers would quickly climb as providers discover the ease of completing tasks. However, she said reporting clinical data isn't quite as seamless. The big challenge, she stressed, is to make sure data is captured properly and in a manner that could be reported to match meaningful use criteria appropriately.

Now comes the crunch. The countdown has started, yet all the preliminary pieces still aren't in place. At press time, McAnally said the expectation was that ONC would announce certifying bodies any day now. Once that happens, vendors, all of which have to recertify to the meaningful use criteria, are expected to make a mad dash to get green-lighted. "Then it's going to be like the gold rush for providers once these vendors are certified because they want their money," she noted, adding providers can begin to qualify for incentive dollars starting Jan. 1, 2011.

For more information on qualifying for incentives and selecting the EHR system most appropriate to your healthcare setting, go online to www.tnrec.org or call 866-514-8595 statewide. Additionally, there are regional offices with field staff to assist providers in East, West and Middle Tennessee.